Need help understanding thyroid panel results(Hyperthyroidism)

[Neda15]

Hi, I have hyperthyroidism and a multinodular goiter. I do not have Graves Disease. I was hoping someone could give me their thoughts on the results of my thyroid panel.  I'll be seeing the doctor soon, but does anyone have an idea why the Total T4 is below range?  I thought it would be higher than that since I have hyperthyroidism.  


TSH 0.02 Range 0.34-5.60
Total T4 6.0   Range 6.09 -12.23
T-Uptake 42.2   Range 32-48.4%
T7 6.3   Range 5.93-13.13 ug/dl

[goolarra]

Ticks would be pretty unpleasant, too.  LOL  That's not, however, a typical  thyroid symptom.

It should be routine to test FT3 and FT4.  However, many of these doctor's are biased by what they learned in med school (how many years ago?) and don't keep up on "recent" developments.  Also, new med students are taught by old doctors, so the problem perpetuates itself.  The tests your doctor ordered tell me she isn't "up" on thyroid developments.

So, your doctor certainly has more information than I do since I haven't seen the results of your U/S or RAIU.  However, I think that she. like many doctors, is fixating on TSH and nothing else.  In my opinion (disclaimer: I'm not a doctor and have no medical training whatsoever), with T4 below range, she should never have put you on methimazole.  Methimazole would further lower your T4 and make you feel more hypo.  Can you tell me more about your symptoms when taking it?

What is the plan going forward?    

[Neda15]

Oops, I should have typed tics not ticks.
I will have to ask to have the free T3, T4 tested.  I would have thought it was just routine, especially for an endocrinologist.

[Neda15]

Thank you goolarra.  The biggest problem I'm having is that I'm exhausted, but the reason I went to the endocrinologist is because of the lumps. I'm thin, but I've always been a thin adult.  I have very dry skin & hair, a slight tremor when I hold my hand out. Even though my heart rate is usually normal it does get slightly fast at times. I can't tolerate heat OR cold and I even wear socks when I sleep. My hands are almost always cold and always have been.

It took 3 months to get in to see the endo and 1 week before that I developed this weird symptom that may not have anything to do with my thyroid.  My head sort of jerks slightly like I'm turning my head.  If you've ever noticed someone with a tick, it's similar to that, but not as noticeable.  That has me worried the most right now and when I told the endo she didn't have anything to say about it.  I'm going to make an appt. with a gp to try and find out about that.  I'm just so stressed out & tired it's hard to make myself do it.

I had an ultrasound & uptake scan done 6 weeks ago.  The nurse told me I have a multinodular goiter & don't have Graves, but I haven't been able to talk to the doctor about my results yet.  She had already prescribed Methimazole to start taking after the scan.  I took it for 3 days and the side effects were so bad I stopped. I know you shouldn't stop taking prescribed medication, but on top of the other side effects the roof of my mouth started itching & I had trouble getting out of bed, had a hard time standing up straight. To 898_1, no, I'm not taking Metformin.

[898_1]

Are you taking Metformin for any chance??

[goolarra]

On what basis were you diagnosed hyper?

Your TSH "looks" hyper, but TSH is a pituitary hormone and can be affected by any number of factors.  

As you mention, TT4 is below range, which indicates you are hypo.  T3U and T7 are both considered obsolete tests and pretty much a waste of money and blood.  Your doctor should be testing FREE T3 and FREE T4 instead of T3U, TT4 and T7.  

Please list your symptoms.